It can be a hassle trying to figure out Medicare by yourself. Sometimes a caregiver or loved one may need or want to help to ensure you receive the proper care and coverage while under Medicare. It can be pretty challenging, especially if you are new to Medicare and unsure of what direction is best for your healthcare needs and budget.
There are several parts of Medicare to sift through and understand, and even more plan options beneficiaries can choose from. Your initial Medicare decisions are critical, as there are various enrollment periods and rules to be aware of so you don’t make a mistake or end up with penalties.
Even after you transition to Medicare, you may need help with things like claims or changing plans in the future. Having a Medicare Authorized Representative can be one way you receive assistance. If you think a Medicare Authorized Representative could benefit you, or if you’re a loved one trying to help someone with their Medicare, keep reading to learn more about what it entails.
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Medicare Authorized Representative
What exactly is a Medicare Authorized Representative?
Appointing someone as your Medicare Authorized Representative means you are selecting a trusted person, such as a family member or friend, to assist you with any Medicare-related concerns. Having an Authorized Representative means you give this person permission to speak to Medicare on your behalf.
What can an Authorized Representative do?
When you appoint a Medicare Authorized Representative, they can assist you with various Medicare needs. This person can help you with things such as your Medicare enrollment, exploring your plan options, and the plan enrollment process.
A Medicare Authorized Representative can also assist you with your Medicare premium payments and payments to other parties, such as copays to your healthcare providers. If any Medicare claim issues or questions arise, your Authorized Representative can also help you with this.
Is there anything you can’t do as an Authorized Representative?
A Medicare Authorized Representative is different from having a health care proxy. The person you appoint does not have the power to make medical decisions for you if you cannot do so yourself.
What about Medigap or Medicare Advantage plans?
It might be a little different if a Medicare beneficiary has a Medicare Advantage or Medigap plan and wants their Authorized Representative to have certain access and permissions. Each plan may have its own privacy policy regarding sharing your personal health information and having an Authorized Representative speak on your behalf.
Your plan may require further authorization in order for your Medicare Authorized Representative to be granted permission to have access to your personal health information and to speak on your behalf when it comes to your private Medicare plan.
Who can become an Authorized Representative?
The Medicare beneficiary chooses an Authorized Representative. This person is typically someone the beneficiary trusts to help them make decisions regarding their Medicare, such as a spouse, family member, or friend.
How can you appoint a representative?
When you’ve made up your mind and are sure you want to appoint a representative, you are ready to fill out the form! There are two ways to appoint a representative:
- Complete, print, and mail the form to the address given in the form directions.
- Log in to your Medicare account to access and submit the form.
How long can someone be an authorized representative?
When making someone your Authorized Representative, you can decide for how long. You can choose to allow this person to be your authorized Representative for only a specific period of time or indefinitely.
The other important thing to note is that you can also change or revoke this decision at any time by sending a written request to the address provided in the form you fill out.
Something to Consider
Medicare can be overwhelming and confusing for many. If you’re considering making someone you trust your Medicare Authorized Representative, discuss it with them to see if it is something that is feasible. Having a trusted person such as a spouse, friend, or family member to help you with these critical healthcare decisions can help relieve you of some of the pressure and stress about your Medicare.
A Medicare Authorized Representative can also help be your advocate in case you have any claim issues or need to make changes to your Medicare in the future.
